Obesity in pulmonary arterial hypertension the pulmonary hypertension association registry

Jeff Min, Rui Feng, David Badesch, Erika Berman-Rosenzweig, Charles Burger, Murali Chakinala, Teresa De Marco, Jeremy Feldman, Anna Hemnes, Evelyn M. Horn, Matthew Lammi, Stephen Mathai, John W. McConnell, Kenneth Presberg, Jeffrey Robinson, Jeffrey Sager, Oksana Shlobin, Marc Simon, Thenappan Thenappan, Corey VentetuoloNadine Al-Naamani

Research output: Contribution to journalArticlepeer-review

14 Scopus citations

Abstract

RATIONALE: Obesity is associated with pulmonary arterial hypertension (PAH), but its impact on outcomes such as health-related quality of life (HRQoL), hospitalizations and survival is not well understood.

OBJECTIVES: To assess the effect of obesity on health-related quality of life (HRQoL), hospitalizations and survival in patients with PAH.

METHODS: We performed a cohort study of adults with PAH from the Pulmonary Hypertension Association Registry, a prospective multicenter registry. Multivariate linear mixed effects regression was used to examine the relationship between weight categories and HRQoL using the Short Form-12 (SF-12) and emPHasis-10 (e10). We used multivariable negative binomial regression to estimate hospitalization incidence rate ratios (IRRs) and Cox regression to estimate hazard ratios (HRs) for transplant-free survival by weight status.

RESULTS: 767 subjects were included: mean age of 57 years, 74% female, 33% overweight and 40% obese, with median follow-up duration of 527 days. Overweight and obese patients had higher baseline e10 scores (worse HRQoL), which persisted over time (p<0.001). The overweight and obese have a trend towards increased incidence of hospitalizations compared to normal weight (IRR 1.34, 95% confidence interval (95%CI) 0.94-1.92 and 1.33, 95%CI 0.93-1.89, respectively). Overweight and obese patients had lower risk of transplant or death as compared to normal weight patients (HR 0.45, 95%CI 0.25-0.80 and 0.39, 95%CI 0.22-0.70, respectively).

CONCLUSIONS: In a large multicenter, prospective cohort of PAH, overweight and obese patients had worse disease-specific HRQoL despite better transplant-free survival compared to normal weight patients. Future interventions should address the specific needs of these patients.

Original languageEnglish (US)
Pages (from-to)229-237
Number of pages9
JournalAnnals of the American Thoracic Society
Volume18
Issue number2
Early online dateOct 21 2020
DOIs
StatePublished - Feb 1 2021

Bibliographical note

Publisher Copyright:
© 2021 by the American Thoracic Society.

Keywords

  • Hospitalization
  • Obesity
  • Pulmonary arterial hypertension
  • Quality of life
  • Survival analysis

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